Meg Seymour, PhD, National Center for Health Research
Covid-19, also called a novel coronavirus, is turning our lives upside down. Many of us are feeling anxious and worried. Anxiety is hard to cope with and happens to everyone, especially during stressful times. Fortunately, there are things you can do to help you when your mind is stuck on worried thoughts. The following techniques will help you manage the symptoms of anxiety and help reduce those anxious feelings.
We’ll start this article with ways to reduce anxiety, and we’ll end with techniques that you can use if you feel that your anxiety is out of control:
Take care of your body
Exercise helps prevent anxiety, and it also helps you feel better when you are already anxious.1, 2 According to research, exercise that gets your heart rate up, as well as slow, gentle exercises both decrease anxiety. You can exercise from the comfort of your own home. If you want to get your heart rate up, you can try doing 100 jumping jacks. If you want gentle exercise, research has shown that both yoga and tai chi reduce feelings of anxiety.3, 4 You can find videos like this on Youtube that can help guide you in exercises.
Research has shown that poor sleep is connected with a number of physical health problems, and a lack of sleep is connected with anxiety and other mental health problems. Not getting enough sleep at night can make you feel more anxious the next day 5, and this anxiety caused by lack of sleep is even worse for people who worry a lot to begin with.6 It is important for adults to get 7 to 9 hours of sleep each night. For tips on how to improve the quality of your sleep, read this article.
Avoid behaviors that make anxiety worse
Things that you put into your body, such as caffeine, alcohol, and nicotine, can affect anxiety in ways that might surprise you. The Food and Drug Administration recommends a limit of 400mg of caffeine a day. There are about 95mg of caffeine in a cup of coffee, which means that roughly 4 cups of coffee is the recommended daily limit.7 Drinking more than this amount can make you feel jittery and anxious 8, and people who already have anxiety are at an increased risk of having anxious reactions to too much caffeine, such as feeling dizzy or having a panic attack.9
People often drink alcohol as a way to “unwind” or “take the edge off” of their anxious feelings. However, anxiety can feel worse when alcohol wears off.10 People who are anxious are more likely to drink too much, which changes the brain and makes it even more likely to become anxious.11 Try to limit your alcohol intake to the recommended amounts, which is up to 1 drink a day for women and up to 2 drinks a day for men.12 If you take any medications for anxiety, talk with your doctor before drinking alcohol. Alcohol can interact with some medications, causing harmful interactions including death.
Many people who smoke or vape say that they do it because it “calms their nerves” and makes them feel less anxious. But scientists have found that the reason people feel better after they smoke or vape is because it relieves the symptoms of nicotine withdrawal.13 In other words, you feel more anxious as a symptom of nicotine withdrawal, but if you smoke or vape that’s a very temporary solution that will make you feel more anxious later. In contrast, research has shown that quitting smoking actually lowers anxiety levels.14 If you smoke or vape, one way to lower your anxiety is to quit. If you are interested in resources to help you quit, you can check out this article.
In addition, the COVID-19 pandemic has raised even more concerns about the safety of vaping. Youths aged 13-24 years old who have used e-cigarettes are more likely to be diagnosed with COVID-19, be tested for the virus, and to experience Covid-19 symptoms.20 Obviously, these symptoms and fear of diagnosis are likely to increase anxiety.
Be mindful of how you use technology
If you find yourself obsessing with worry over what you are reading or watching on the news, consider reading or watching it less. Instead of constantly accessing the news, try scheduling certain times a day for the news, and keep your mind off of it during the rest of the day. Try to take regular breaks from the coronavirus warnings if they are causing you to worry. You want to be informed and do what is needed to stay safe, but you don’t need to hear warnings all day long.
Social support may be hard to get under the constraints of social distancing, so it can help to call, text, or video chat with friends and family, rather than scrolling their Facebook or Instagram pages. Research shows that people who use more social media sites and apps have higher anxiety, and the relationship between social media use and anxiety is even stronger for people who use it a lot at night.15, 16 We don’t know if using social media makes people anxious, or if people who are already anxious use social media more than other people. But there is evidence that using social media at night is related to poor quality of sleep, and poor sleep is associated with anxiety.16
Being lonely makes the body release stress hormones, and that can make you feel anxious.17 If you feel lonely, try reaching out to others over the phone or video chat, rather than just browsing Facebook or other social media. If other people aren’t available, you might want to contact a local animal shelter and ask if they need anyone to foster a dog, cat, or other animal. Caring for an animal can be very satisfying, because taking care of others feels good, and because animals can be great companions. In fact, research has shown that pets are good for your health.
Practice gratitude and kindness
Research has shown that regularly practicing gratitude and being kind to others helps lower anxiety.18 Keep a gratitude journal. Each day, write down 5 things that you are grateful or thankful for. These 5 things could be things that happened that day, such as receiving a nice note from a friend, or they can be “big picture” things that you are feeling especially grateful for, such as your loved ones.
Doing good deeds for other people also lowers anxiety.18 You can keep a journal about this as well. Each day, write down up to 5 different things that you did to help someone else that day. They can even be little things, like holding the door open for someone. What is important is both that you helped other people and that you reflected on it at the end of the day.
What if I feel out of control?
If you feel like the world is spinning out of control, here are some techniques that can help:
Use breathing techniques
No matter what else is out of control, one thing you can control is your breathing. Focusing on your breath can help you return to a sense of calm. One type of breathing you can try is called the 4-7-8 technique.19 Start by sitting comfortably, with your feet on the floor. Your eyes can be either open or closed. Breathe out, and then:
- Breathe in through your nose, counting to 4 in your mind.
- Hold your breath, counting to 7 in your mind.
- Slowly breathe out through your mouth, counting to 8 in your mind.
- You can repeat this 3 times for a total of 4 breaths.
Countdown using your 5 senses
If your anxiety feels out of control and you feel like your head is spinning, you can regain a sense of control by activating each of your 5 senses. One way to do this is to “countdown” using each of your senses. Sit comfortably, pay attention to the world around you, and say out loud:
- 5 things that you can see.
- Look around and say 5 different things around you that you can see.
- 4 things you can touch.
- What can you feel around you? It can be anything, from the fabric of your clothes to the feeling of the floor on your bare feet.
- 3 things you can hear.
- Maybe you can hear cars honking outside or the sound of the wind.
- 2 things you can smell.
- Whether you are indoors or outdoors, try smelling two different things.
- 1 thing you can taste.
- What does the inside of your mouth taste like? Try chewing a piece of gum or a mint.
Anxiety can make us feel disconnected from ourselves and from the world. Countdowns are a great way to engage your senses and come back to a sense of feeling connected.
Anxiety can be scary, but it is possible to overcome it. If you are feeling like you are spinning out of control with worry reading the news about the coronavirus, breathing exercises and counting down your 5 senses can help. Regularly engaging in healthy behaviors, such as exercise and practicing gratitude, can lower your anxiety levels in the long-term. If you still feel like your anxiety is out of control, you can talk with your doctor and also see a therapist. You can find a therapist in your area using this website.
- Carek, P. J., Laibstain, S. E., & Carek, S. M. (2011). Exercise for the treatment of depression and anxiety. The International Journal of Psychiatry in Medicine, 41(1), 15-28.
- Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., … & Schuch, F. B. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249, 102-108.
- Broughton, M. K. (2016). Yoga for depression and anxiety: A review of published research and implications for healthcare providers. Rhode Island Medical Journal, 99(3), 20.
- Caldwell, K. L., Bergman, S. M., Collier, S. R., Triplett, N. T., Quin, R., Bergquist, J., & Pieper, C. F. (2016). Effects of Tai Chi Chuan on anxiety and sleep quality in young adults: lessons from a randomized controlled feasibility study. Nature and science of sleep, 8, 305.
- Popular Science. Lack of sleep looks the same as severe anxiety in the brain. Popsci.com https://www.popsci.com/sleep-deprivation-brain-activity/. 2018.
- Psych Central. Sleep Loss Increases Anxiety — Especially Among Worriers. Psychcentral.com. https://psychcentral.com/news/2013/06/27/sleep-loss-increases-anxiety-especially-among-worriers/56531.html. 2018.
- U.S. Food and Drug Administration. Spilling the Beans: How Much Caffeine is Too Much?. Fda.gov. https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much. 2018.
- U.S. National Library of Medicine. Caffeine. Medlineplus.gov. https://medlineplus.gov/caffeine.html. Updated 2019.
- Nardi, A. E., Lopes, F. L., Freire, R. C., Veras, A. B., Nascimento, I., Valença, A. M., … & Mezzasalma, M. A. (2009). Panic disorder and social anxiety disorder subtypes in a caffeine challenge test. Psychiatry research, 169(2), 149-153.
- Healthline. Alcohol and Anxiety. Healthline.com. https://www.healthline.com/health/alcohol-and-anxiety. 2016.
- American Addiction Centers. The Connection between Anxiety and Alcohol. Americanaddictioncenters.org. https://americanaddictioncenters.org/alcoholism-treatment/anxiety. Updated 2019.
- Centers for Disease Control and Prevention. Dietary Guidelines for Alcohol. Cdc.gov. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm. Updated 2019.
- Smokefree. Anxiety & Smoking. Smokefree.gov. https://smokefree.gov/challenges-when-quitting/cravings-triggers/anxiety-smoking.
- Medical News Today. Quitting Smoking Reduces Anxiety. Medicalnewstoday.gov. https://www.medicalnewstoday.com/articles/254544#1. 2013.
- Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in human behavior, 69, 1-9.
- Woods, H. C., & Scott, H. (2016). # Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of adolescence, 51, 41-49.
- Cleveland Clinic. What Happens in Your Body When You’re Lonely?. Health.clevelandclinic.org https://health.clevelandclinic.org/what-happens-in-your-body-when-youre-lonely/. 2018.
- Kerr, S. L., O’Donovan, A., & Pepping, C. A. (2015). Can gratitude and kindness interventions enhance well-being in a clinical sample?. Journal of Happiness Studies, 16(1), 17-36.
- Weil, A. Three Breathing Exercises And Techniques. Drweil.com. https://www.drweil.com/health-wellness/body-mind-spirit/stress-anxiety/breathing-three-exercises/. 2016.
- Gaiha SM, Cheng J, Halpern-Felsher B. Association between youth smoking, electronic cigarette use, and COVID-19. Journal of Adolescent Health. 2020;67(4):519-523. doi:10.1016/j.jadohealth.2020.07.002.